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Regulatory Barriers Impair Alignment of Biopharmaceutical Price and Value
This white paper highlights the challenges biopharmaceutical manufacturers and payers face when developing value-based contracts.
A Comparison of Coverage Restrictions for Biopharmaceuticals and Medical Procedures
Payer evaluation and coverage of pharmaceuticals and medical procedures may differ independent of their clinical benefit. Therapy access depends on factor other than cost and clinical benefit,…
Peer-reviewed Journal Editors' Views on Real-world Evidence
A study published in the International Journal of Technology Assessment in Health Care reveals that real-world evidence is considered valuable by the editors of peer-reviewed journals—if it meets…
Insurance Switching and the Mismatch Between the Costs and Benefits of New Technologies
The peer-reviewed study examined the disconnect between the short-term budget impact of a treatment and its downstream effects on payers and society.
Toward Better Value
There is a disconnect between the important role employers believe their pharmacy benefit managers (PBMs) play in helping to manage prescription drug benefits and employers’ perceptions of the…
Real-World Evidence: Useful in the Real World of United States Payer Decision-Making? How? When? And What Studies?
Research published in Value in Health on real-world evidence provides a deeper understanding of when and how managed care organizations use RWE in decision-making, and how to increase its use.
Information Wanted: Finding the Balance in Pharmaceutical Evidence Exchange With Payers and Providers
Payers and providers were surveyed to understand the type of health care economic information (HCEI) they desire and value in the current and future health care environment, as well as the potential…
Optimization of Medication Use at Accountable Care Organizations
This study assesses a broad range of factors related to how accountable care organizations optimize medication use and meet financial and quality metrics.
Why Value Framework Assessments Arrive at Different Conclusions: A Multiple Myeloma Case Study
Researchers conducted cross-framework comparisons of multiple myeloma assessments using four value assessment frameworks and examined the consistency of findings across three case studies.
Health Plan Use of Patient Data: From the Routine to the Transformational
As the abundance and variety of patient data elements and sources continue to grow, health plans seek opportunities to deepen insights from multiple sources of patient data to shape care delivery,…
Improving Oncology Quality Measurement in Accountable Care
This comprehensive white paper from the National Pharmaceutical Council and Discern Health identified gaps in accountable care quality measure sets for cancer, which can lead to missed opportunities…
Is Real World Evidence Used in P&T Monographs and Therapeutic Class Reviews?
Payers infrequently used real-world evidence (RWE), or information on how treatments work in the real world, to guide their medication coverage and reimbursement decisions, according to research…
Value Assessment Frameworks: Are They Up To The Challenge?
In this article published on the Health Affairs Blog, NPC researchers Dr. Robert Dubois and Kimberly Westrich ask: Are value assessment frameworks ready to compare the health and economic impacts of…
Concerns Around Budget Impact Thresholds: Not All Drugs Are The Same
A study published in Value in Health explores the potential impact of using budget thresholds as budget caps (e.g., cannot spend more than a set dollar amount) for individual drugs.
Comparison of Value Framework Assessments for Multiple Myeloma
In this NPC-funded study conducted by the Lewin Group, four existing value assessment frameworks were compared head to head to understand how each framework would approach the same condition,…
Does a One Size Fits All Cost-Sharing Approach Incentivize Appropriate Medication Use?
Patients contribute to health care costs through out-of-pocket expenses, like copays and coinsurance. These cost-sharing mechanisms are intended to help payers manage costs and encourage more…
Does a One-Size-Fits-All Cost-Sharing Approach Incentivize Appropriate Medication Use? A Roundtable on the Fairness and Ethics Associated with Variable Cost Sharing
A study convened an expert roundtable of patient, payer, and employer representatives to review four case studies to understand when it would be more (or less) acceptable to require patients with the…
Improving Oncology Quality Measurement in Accountable Care: Filling Gaps with Cross-Cutting Measures
According to a study, gaps in the quality measures used by accountable care programs to assess cancer care may obscure problems in care delivery and lead to missed opportunities for improvement of…
Assessing Value: Promise and Pitfalls Conference Summary Report
At NPC's conference, Assessing Value: Promise and Pitfalls, top experts in their fields united to discuss value assessment as it impacts payers, patients, providers and pharmaceutical innovators.
Comparison of Value Assessment Frameworks Using the National Pharmaceutical Council’s Guiding Practices for Patient-Centered Value Assessment
NPC worked with The Lewin Group to conduct an independent analysis of the extent to which five major value assessment frameworks address or align with NPC’s Guiding Practices for Patient-Centered…